1. Field of the Invention
This invention relates to surgical devices and in methods and in particularly to devices that are used in arthroscopic surgical procedures involving knee ligament reconstructive surgery.
2. Background
The present invention is in a arthroscopic surgical instrument and method for its use in a surgical procedure for replacement of an anterior cruciate ligament in tibial and femoral bony tunnel sections that, with the knee bent appropriately, form a straight tunnel. The ligament graft, for example, a bone-tendon-bone graft is to have one end secured endosteally in the femur endosteum with its other end placed in tension and is secured, as by stapling to the tibia anteromedial cortex. To provide this endosteal fixation in femur endosteum, the present invention provides a drill guide instrument for enabling a surgeon to form a passage from a point on the femur medial condyle notch to intersect the ligament tunnel in the femur endosteum. A fastener is then fitted through the formed passage to intersect and turn into the ligament end, providing a set screw type mounting of the ligament in the femur tunnel section. The present invention provides for aiming that passage to drill through a point on the roof of the intercondyle notch to exactly intersect the ligament graft end at a certain acute angle.
3. Prior Art
The present invention is utilized in arthroscopic surgical procedures for replacement of a knee cruciate ligament involving forming distal femur and proximal tibia bony tunnel sections that with the knee bent appropriately form a straight tunnel that receives a ligament secured therein. Such ligament replacement surgical procedure can involve drilling, from without the knee, a tunnel to intersect the formed ligament tunnel. The present inventor is a co-inventor of several drill guide inventions that perform this function. Specifically, a U.S. Pat. No. 4,901,711 and a U.S. patent application, Ser. No. 522743, that was filed on May 14, 1990, show drill guides for drilling from without the knee. Distinct therefrom the present invention provides for forming a passage within the intra-articular joint from a point on the roof of the intercondyle notch into the femur endosteum to intersect at a shallow acute angle, the femur section of the ligament tunnel. Wherethrough a set screw, or the like, can be fitted into a ligament end, such as a bone end of a bone tendon, bone, or the like, arranged therein, to endosteally secure that ligament end.
Additional to the patent and patent application set out above, the present inventor is the co-inventor of several patents that show a utilization of a straight bony tunnel in surgical procedures for repair or replacement of the anterior or posterior cruciate ligament. Such patents, for example include, "Ligament Anchor Attachment, Method and Apparatus" U.S. Pat. No. 4,772,286; "Ligament Attachment Anchor System" U.S. Pat. No. 4,870,957; a patent application entitled "Endosteal Fixation Stud and System" Ser. No. 465,914, filed Jan. 16, 1990, now U.S. Pat. No. 4,997,433. None of which patents, however, show a guide that is like the instrument of present invention.
Additional drilling systems for use in arthroscopic surgical procedures are shown in patents to: Sapeya et al, U.S. Pat. No. 4,739,751; Cho, U.S. Pat. No. 4,257,411; Hourahane et al, U.S. Pat. No. 4,535,768; Hourahane, U.S. Pat. No. 4,672,957; and a United Kingdom patent to Lovell et al, No. 2,078,528. All of which devices and arrangements provide for drilling from without the knee to a point in or around the intra-articular joint. Whereas, the present invention provides for forming a passage from a point within the intra-articular joint to intersect a ligament tunnel.
Functionally similar to the above cited patents, patents to Walt et al, U.S. Pat. No. 4,920,958; Purnell et al, U.S. Pat. No. 4,781,182; and Dunbar, IV, U.S. Pat. No. 4,708,139, also show drill guide arrangements for forming a hole from without a knee to a point in the intra-articular joint, as do patents to Seadholm et al, U.S. Pat. No. 4,668,223 and a European patent application No. 0126529.
Heretofore, within the knowledge of the inventor, there has not existed an instrument for guiding drilling by a surgeon to arthroscopically form a passage from a point on the roof of the intercondyle notch to exactly intersect a femoral tunnel section, which passage is for fitting a set screw, or like fastener, therein to endosteally secure the femoral end of a ligament graft within the femur endosteum.